Washington ? The Supreme Court cleared the way Monday for an Indiana state law that places some of the nation’s most severe restrictions on abortions, including requirements that a woman be counseled face-to-face about the risks and offered pictures of what her fetus might look like.

The high court turned down an appeal from abortion clinics in Indiana claiming the in-person counseling sessions would force some women to forgo abortions or to risk their health by postponing the procedure far into pregnancy.

“This is an outrageous law that leaves many women without access to abortions, or certainly places a heavy burden, an undue burden, on a woman’s right to choose,” said Kate Michelman, president of the abortion rights group NARAL Pro-Choice America.

But Mike Fichter, executive director of Indiana Right to Life, an anti-abortion group, said, “For the first time, abortion providers in Indiana will be required to give women information about the risks. We’re glad that the court battles look like they’re finally over.”

The high court action means Indiana may begin fully enforcing a law passed eight years ago that requires in-person counseling and an 18-hour waiting period before a woman can get an abortion.

In practice, the Indiana law and similar measures on the books in four other states require women to make two trips to an abortion clinic. Opponents said that made the procedure more difficult to obtain for poor women or those who must travel long distances.

Making two trips often means leaving work for two days, finding a place to stay overnight and arranging child care at home, said Janet Crepps, staff lawyer for the Center for Reproductive Rights. Women may also have a hard time explaining their absence from work, school or a husband or partner who does not know about the pregnancy, Crepps said.

Opponents of the Indiana law said research showed that similar laws in Mississippi and Utah forced women to put off abortions because of scheduling difficulties or travel out of state to have abortions.

Louisiana and Wisconsin also have similar in-person counseling requirements.

The Supreme Court did not comment in rejecting the case, which could have offered a new opportunity to review when state restrictions on abortion become unconstitutional. Nearly every state places some restriction on the availability of the procedure, including requirements that women wait a day or so after requesting an abortion and that they receive certain medical or legal information beforehand.

The high court has allowed a variety of restrictions, so long as they do not place an “undue burden” on a woman’s ability to get an abortion.

Waiting periods and laws requiring women to get information ahead of time are not new, but Indiana’s law goes further than most states in combining the two restrictions.

Abortion rights supporters claim such restrictions are meant to chip away at the right to an abortion secured by the Supreme Court in the Roe v. Wade ruling 30 years ago. Abortion opponents generally support such restrictions as reasonable ways to make sure the procedure is performed responsibly, although for many they do not go far enough.

“Waiting periods will not end abortion,” said Erik Whittington, spokesman for the American Life League. “Although these bills may be well-intentioned, they do not address the fact that abortion kills a baby and should never be allowed under any circumstance.”